Pretreatment or post exposure treatment for exposure to a toxic substance by pulmonary delivery (inhaler) of a bioscavenger

ABSTRACT

The present invention relates to a treatment by pulmonary delivery of bioscavengers to animals as an effective antidote to prevent toxicity produced by exposure of an animal to nerve agents and other toxic substances.

CROSS-REFERENCE TO RELATED APPLICATIONS

This application is related to U.S. provisional application Ser. No.60/425,726 filed Nov. 13, 2002, the contents of which are incorporatedherein by reference.

FIELD OF THE INVENTION

The present invention relates to a treatment by pulmonary delivery ofbioscavengers to animals as an effective antidote to prevent toxicityproduced by exposure of an animal to nerve agents and other toxicsubstances. In one embodiment, the disclosure relates to the delivery offunctional bioscavenger cholinesterase molecules as a protective in vivotreatment against poisoning by nerve agents and drugs including but notlimited to cocaine, heroin and succinylcholine.

BACKGROUND OF THE INVENTION

Exposure to organophosphates (OPs) in the form of nerve agents (e.g.sarin, soman and VX) and pesticides (e.g., paraoxon, parathion andmalathion) may result in acute cholinergic effects by inhibition ofacetylcholinesterase (AChE), permitting continuous firing of neurons andthereby producing toxicity, behavioral deficits and death. Of late, suchagents pose an ever increasing military and civilian threat due toheightened terrorist activity. Traditional multi-drug treatment forpoisoning by OPs consist of a combination of drugs such as carbamates(e.g. pyridostigmine), antimuscarinics, reactivators of inhibited AChEand anti-convulsants in postexposure modalities. These treatments,however, are far from optimal and do not prevent respiratory stress,tremors, convulsions and behavioral impairments. In recent years,exogenous administration of “self” native enzyme scavengers e.g.cholinesterases (ChE) have been successfully used in many species (mice,rats and monkeys) as safe and efficacious prophylactic and post exposuretreatments due to their capacity to scavenge OPs in the blood andrapidly detoxify the active components before inhibition of theendogenous targets can occur. Such bioscavengers are shown to be highlystable, specific and efficient, to have long half-lives in homologoussystems and capable of functioning under physiological conditionswithout producing immunological or other adverse side effects. Inaddition to nerve agents, certain bioscavengers can be also used toneutralize drugs such as cocaine, heroin and succinylcholine (a cause ofapnea).

SUMMARY OF THE INVENTION

This present invention provides noninvasive and needleless methods forthe inhalation delivery of a bioscavenger capable of rapidly ensuringentry of the bioscavenger into the blood so that (a) a real timeresponse to assault by a toxic substance is accomplished, as e.g. in anincoming attack involving a nerve agent, and (b) first responders tocivilian attacks can upgrade their protection between the time they getnotification of a chemical incident and the time they arrive on thescene. The adaptability and portability of an inhaler also means thatnew modified forms of the scavenger molecules as well as the co-deliveryof additional “enhancing” molecules can be supported in order toincrease the scavenging capabilities with reduced treatment doses.

In one embodiment, the present invention describes a method for thepulmonary delivery of a native or recombinant bioscavenger for the invivo detoxification/neutralization of organophosphates including nerveagents, pesticides, insecticides as well as drugs such as heroin,cocaine and succinyl choline. The bioscavenger is administered as asingle or multiple dose prophylactic (preexposure) or therapeutic (postexposure) treatment.

In one embodiment, the present invention describes a method for thepulmonary delivery of native or recombinant butyrylcholinesterase forthe in vivo detoxification/neutralization of organophosphates includingnerve agents, pesticides, insecticides as well as drugs such as heroin,cocaine and succinyl choline. The butyrylcholinesterase is administeredas a single or multiple dose preexposure or post exposure treatment.

Pursuant of the present invention, delivery of native and recombinant(r) BChE molecules, either in powder or liquid form by inhalation can beused for (i) Protection against chemical warfare agents interrorist/battlefield situations; (ii) Clinical treatment of drugoverdosing with cocaine, heroin; (iii) Alleviating life threateningconditions such as succinylcholine-induced apnea; (iv) neutralization orinactivation of toxic substances following pre or post exposure of firstresponder civilians and farmers to nerve agent, insecticides orpesticides. Succinylcholine is an exogenously administered drug whichcauses muscle relaxation and is given prior to surgery. This includesthe muscles required for breathing. In people lacking BChEsuccinylcholine cannot be cleared, resulting in apnea (inability tobreathe). This can be overcome by treatment with BChE.

In one embodiment, the invention provides a method for the treatment ofan animal for the detoxification or neutralization of a toxic substancewhich comprises administering to said animal a bioscavenger moleculethat prevents the toxic effects of said toxic substance in the animal,wherein said bioscavenger molecule is administered to said animal by aninhalation process. In a preferred embodiment, the animal is a human.

In one embodiment, the bioscavenger is administered by inhalationdelivery of a dose between 1 and 10 mg per Kg of body weight of saidanimal.

In another embodiment, the bioscavenger is administered by inhalationdelivery of a dose, of bioscavenger that is sufficient to prevent thetoxic effects of 2 LD50 of, e.g., a nerve agent

In another embodiment, the invention provides single or multiple dosepreexposure administration of said bioscavenger. In another embodiment,post exposure treatment with a bioscavenger is given in combination withan oxime that reactivates said bioscavenger. The bioscavenger can be anative blood-derived product or a recombinant molecule in either amonomeric or tetrameric form.

In a preferred embodiment, said recombinant molecules are glycosylatedin vitro to mimic the structure and function of the native molecule.

DETAILED DESCRIPTION OF THE INVENTION

In general terms, the use of an effective pretreatment using nerve agentscavenger such as BChE could preclude the necessity of carrying orwearing protective clothing or masks because high levels of thescavenger in the blood would neutralize and thus protect against nerveagents in the absence of protective equipment. This feature is importantto soldiers in the Army in battlefield conditions and to the Marines whoguard Embassies worldwide and who are unable to don protective clothing.In terms of non-military personnel, treatment with bioscavengers isimportant to any civilian first responders who must enter an exposedarea, those exposed to environmental toxins in insecticides and thosesuffering drug overdose and apnea.

Based on availability, broad spectrum efficacy and safety, thecholinesterase, butyrylcholinesterase (BChE) is the only pan scavengercandidate sufficiently developed for human treatment and is thepreferred bioscavenger of the present invention. A pan scavenger is onewhich works on multiple nerve agent targets. Since cholinesterases arestoichiometric inhibitors (one molecule of enzyme neutralizing onemolecule of nerve agent), humans require a large dose of scavenger e.g.150-200 mg (˜3 mg/Kg) of BChE, in order to protect against an exposureof 2 LD₅₀ of nerve agent. While bioscavengers can be administered viaIM, IV, transdermally or by pulmonary routes prior to exposure, aninhaler is by far the simplest, safest and most efficient means ofdelivery. Traditionally, bioscavenger drugs/treatments have beenadministered orally or via the intramuscular route using autoinjectors.Major limitations to the use of the commonly used modes of delivery isthe inability to deliver large molecules (transdermal patches), a longdelay in reaching blood peak levels of bioscavenger activity, majorsoreness at the injection sites and potential infections (intramuscular)and the impracticality in battlefield/high risk conditions ofintravenous injections. By contrast, pulmonary administration ofpeptides and proteins can be expected to lead to higher and more rapidrates of systemic absorption than other non-invasive routes because thealveolar epithelium where absorption takes place is thin and has a largesurface area (˜1,500 sq ft). Pulmonary delivery is performed viaintroduction of the bioscavenger through the nose or mouth via inhaleror nebulizer. In a preferred embodiment, delivery is by mouth with aninhaler.

A critical feature required of any effective nerve agent scavenger isthat as a pre or post exposure treatment, it must (i) have goodstability, that is, circulate in the blood at high concentrations forprolonged periods and (ii) in emergency conditions, the enzyme mustreach peak levels as quickly as possible. To prevent toxicity, nerveagents must be reduced to a level below their median lethal dose withinone blood circulation time.

Scavenger enzymes are usually complex glycoproteins and stability of themolecules is greatly influenced by glycosylation profiles, efficiency offolding and multimerization. In this regard, unlike the nativeblood-derived forms, recombinant prophylactic/therapeutic moleculesproduced by genetic engineering e.g. BChE, exhibit microheterogeneity inthe sugar residues which negatively impacts on the rate of clearance invivo and may limit their use as human treatments. In the presentinvention, this deficiency is overcome by in vitro glycosylationmethodologies which complete or correct sugar profiles of the“incorrectly” expressed recombinant protein and produce a form of thescavenger which mimics the native form in structure and pharmacokineticfunction. As therapeutic human treatments, “remodeled sialyted”recombinant molecules, in contrast to native plasma-derived molecules,should not suffer from batch to batch variability or from potentialsafety issues associated with contaminating infectious agents (HIV-1,hepatitis, prions, etc.)

It is understood that the present invention is not limited to theparticular methodology, protocols, and reagents, etc., described herein,as these may be substituted or altered without deviating from theinvention, and will be understood by one of ordinary skill in the art.It is also to be understood that the terminology used herein is used forthe purpose of describing particular embodiments only, and is notintended to limit the scope of the present invention. It must be notedthat as used herein and in the appended claims, the singular forms “a,”“an,” and “the” include plural reference unless the context clearlydictates otherwise.

Unless defined otherwise, all technical and scientific terms used hereinhave the same meanings as commonly understood by one of ordinary skillin the art to which this invention belongs. Prevention of toxic effectsof a toxic substance “in” an animal is meant to include any toxiceffects that may manifest “on” the animal, as in the case for toxiceffects on the skin or other exposed surface. Preferred methods,devices, and materials are described, although any methods and materialssimilar or equivalent to those described herein can be used in thepractice or testing of the present invention. All references citedherein are incorporated by reference herein in their entirety.

In a preferred embodiment, the invention provides methods for thedelivery of a homologous bioscavenger. In the treatment of humans, anexample of a homologous bioscavenger would be the human BChE product,which can be blood derived or recombinant. In the absence of anavailable homologous bioscavenger, a single treatment with heterologouscan be performed. If repeated administrations are required as in longterm pre-exposure protection, then it must be homologous because thebody would make an immune response to a foreign protein and eliminatethe protein from the body.

The bioscavenger can be administered in a powder or liquid droplet form.

It is one object of the present invention to deliver a variety ofscavenger molecules including but not limited to native ‘self’ enzymemolecules including, but not limited to, (butyrylcholinesterase (BChE),acetylcholinesterase (AChE)), carboxylesterase (CaE), paraoxonase, andbacterial enzymes such as organophosphate hydrolases (OPH),organophosphorous acid anhydride hydrolases (OPAA) and parathionhydrolase. For optimal efficiency, native molecules must be homologouswith the recipients (Example 3). Life Sciences. Vol 72, p 125 2002.

It is another object of the present invention to deliver scavengermolecules that have been successfully used as a safe and efficacioustreatments to prevent poisoning by organophosphate (OP) compounds in theform of nerve agents including but not limited to organophosphates suchas sarin (O-isopropyl-methylphosphonofluoridate),VX (ethyl-S-2-diisopropylaminoethyl-phosphano-thiolate), MEPQ(7-(Methylethoxyphosphinyloxy)-1-methylquinon-linium iodide), soman(pinacolylmethl-phosphonofluoridate), DFP=diisopylfluorophosphateparaoxon, malathion and parathion.

In one preferred embodiment, the bioscavenger is administered as atetramer. In another embodiment, the bioscavenger is administered as amonomer. In some embodiments, the bioscavenger is a recombinantmolecule. The bioscavenger molecule can be a recombinant moleculeproduced in vitro in mammalian or insect cells, or in transgenic plantsor livestock.

In one embodiment, the invention provides a method of inhalationdelivery of an altered bioscavenger which comprises a mutation withincreased bioscavenging efficacy, for example as in E197Q BChE or E202QAChE mutations. In another embodiment, the invention contemplates thepost-exposure co-administration of the bioscavenger with an oxime whichreactivates said bioscavenger. In some preferred embodiments, the oximeis selected from the group consisting of 2-PAM, HI6, toxogonin, TMB4.

The present invention provides an efficient, highly manageable anduser-friendly means of delivery by inhalation (puffer) of bioscavengermolecules e.g. BChE, AChE in sufficient amounts required for protectionagainst toxicity by nerve agents, insecticides and drugs. In the case ofa stoichiometric (i.e., “BChE-like”) bioscavenger alone, ˜150-200 mg (˜3mg/Kg) is required to protect against an exposure of 2 LD₅₀ of nerveagent.

The methods disclosed herein encompass the use of inhalers to administereither powder or liquid forms of the bioscavenger, depending on thechemical properties of the candidate molecules (see Example 1). In onepreferred embodiment, the bioscavenger is administered prophylactically,i.e., over a period of several weeks prior to any anticipated orpossible exposure to the toxic agent. It is presently contemplated thata preferred dosage is delivered at a rate of ˜10 puffs from a powderinhaler (˜15 mg/puff of BChE) and that this dosage will initiallyprotect against high levels of toxin exposure within 30 minutes. In apreferred embodiment, the treatment is repeated about 10 times on thefirst day, with maintenance puffs thereafter sufficient to provideprotection.

In another embodiment, the invention provides methods of an initialadministration of a bioscavenger rapidly across the pulmonaryepithelium, as in the case of an impending (i.e, within 30-60 minutes)exposure to the toxic substance. In this embodiment, a truncated monomerbioscavenger molecule is administered so that the bioscavenger is morerapidly enters the blood.

It is one object of the present invention to develop an adaptable,noninvasive and needleless delivery system capable of rapidly ensuringentry of the bioscavenger into the blood so that (a) a real timeresponse to an incoming attack would not be unreasonable, (b) civilianfirst responders could upgrade their protection between the time theyget notification of a chemical incident and the time they arrive on thescene and (c) an injured soldier/victim can easily receive passivebioscavenger delivered by an another soldier/associate.

As a receptor or soluble receptor, the bioscavenger agent binds,sequesters, and clears the toxin as a complex from the body. As anenzyme, the agent binds, inactivates by hydrolytic or non-hydrolyticprocesses, resulting in toxins that are no longer harmful to mammaliantissues and/or are removed more rapidly from the host. Inactivation canoccur, but is not limited to enzymatic cleavage, blocking of reactivemoieties, masking of active site(s), sequestering to certain tissues,and/or clearance of the toxin as a bound or unbound complex.

It is another object of the present invention to deliver scavengermolecules that have been successfully used as a safe and efficaciousanti-toxicants of nerve agents as both pre-exposure and post-exposuretreatments.

It is another object of the present invention to deliver scavengermolecules that have been successfully used as a safe and efficaciouspost-exposure treatment to overcome drug overdosing such as cocaine andheroin.

It is another object of the present invention to deliver scavengermolecules that have been successfully used as a safe and efficaciouspost-exposure treatment to prevent apnea induced by the muscle relaxantsuccinylcholine.

Transpulmonary administration of peptides and proteins can be expectedto lead to higher rates of systemic, absorption because of a largesurface area (1,500 sq ft). However, transpulmonary administration ofhigh molecular weight compounds is almost always incomplete, because ofabsorption barriers in the alveolar epithelium. Permeation enhancers canincrease the bioavailibility of inhaled peptides and proteins in theblood by for example, increasing the paracellular permeability throughtight junctions, a mechanism that depends on Ca++ channels.

In one embodiment of the present invention, protection against agent ordrug toxicity is achieved using pulmonary delivery of any form of thescavengers in combination with permeation enhancers including but notlimited to oleic acid, dimethyl-b-cyclodextrin and citric acid andpolyethylene glycol (PEGylation).

The methods disclosed herein encompass the delivery of homologousrecombinant bioscavenger molecules. The scavenger genes in question arecloned into the appropriate mammalian or insect cell expression vector(Example 4) or plant expression vector (Example 5). It is contemplatedin the present invention that a transgenic construct of interest can bedelivered to mammalian or plant cells by viral-mediated or non-viralmediated means. Recombinant virus vectors utilized in the presentinvention include, but are not limited to (I) retroviral vectors,including but not limited to vectors derived from a Moloney murineleukemia virus (MoMLV) or a myeloproliferative sarcoma virus (MPSV) (ii)adenovirus vectors (iii) adeno-associated vectors (iv) herpes simplexvirus vectors (v) SV40 vectors (vi) polyoma virus vectors (vii)papilloma virus vectors; (viii) picornavirus vectors; and, (ix) vacciniavirus vectors. Depending on the virus vector system chosen, techniquesavailable to the skilled artisan are utilized to infect the target cellof choice with the recombinant virus vector.

In some embodiments, these scavenger molecules are highly active complextetrameric, glycoproteins e.g., BChE produced by the co-expression of apeptide containing a proline-rich attachment domain (PRAD) in theexpressing cells with the cholinesterase gene (Example 7).Alternatively, PRAD protein can be added in vitro to monomeric anddimeric forms of the scavenger molecules to effect tetramerization.

The methods disclosed herein encompasses methods for production ofrecombinant bioscavenger molecules in transgenic plants (Example 5). amammalian cell system in vitro e.g. CHO (Example 6) as well as in thebreast milk of transgenic livestock e.g. pigs, cattle and sheep.

In one preferred embodiment, the methods disclosed herein encompass adevice for the delivery of homologous native (blood derived) BChEmolecules that are purified, where appropriate, by procainamide and DEAEchromatography and administered alone or in combination with othermolecules. In one embodiment, these scavenger molecule are complextetrameric, glycoproteins such as butyrlcholinesterase (EC3.1.1.8acylcholine achydrolase, pseudocholin-esterase, non-specificcholinesterase), a serine esterase (MW=345,000) comprised of fouridentical subunits containing 574 amino acids and held together bynon-covalent bonds and contains 36 carbohydrate chains (23.9% byweight).

In addition to tetrameric molecules, monomeric BChE may be generated byinserting a stop codon at G534. Thus the mutant monomeric moleculeproduced lacks the 41 C-terminal residues and thus the functionaltetramerization domain required for tetramer formation and in vivostability (Example 8). The monomer has several advantages despite thefact that its stability in plasma is very poor. In addition tothe>8-fold increase in activity per ml of CHO supernatant, a monomer maybe able to more rapidly cross the blood-brain barrier and exhibit muchhigher bioavailablity in the plasma following delivery via inhalers thanthe larger tetrameric molecules. In one embodiment, monomeric molecules,despite being ineffective in maintaining long term protection comparedto the highly stable tetramers, may be highly efficacious in emergencysituations that require real time responses and rapid treatment orbooster administrations.

As a complex recombinant glycoprotein, a scavenger may requireadditional post-translational modifications to enable the agent toprovide the necessary disabling function(s) similar to the nativeprotein. Such glycoproteins are often produced with either incomplete orwrong sugar profiles compared to their plasma derived counterparts. Forexample: 1) The lack of a functional a,2,6-sialyltransferase (ST) genein CHO cells 2). The presence of xylosidayed- and fucosylated-type sugarchains in many plant-derived glycoproteins and the absence of sialicacid in plants 3). The presence of galactosyl transferases in pigsresulting in the potential surface expression of a, 1.3 galactose, whichis not normally found in humans. Several approaches that are availableto overcome these innate deficiencies have either involved exposingrecombinant proteins in vitro to enzymes such as exoglycosidases andsialyltransferases (Example 9) or introducing liver-derived enzymebeta-galactoside alpha-2,6-sialyltransferase cDNA by gene transfer intothose cells producing the recombinant protein. The in vitroincorporation of sialic acid into recombinant proteins (developedspecifically to allow efficient sialic acid capping ofbeta-galactose-exposed termini) has been highly successful. Suchfindings are in agreement with data showing that liver (the in vivosource of many of these highly sialylated glycoproteins) containsialyltransferase, involved in the sialylation of O-glycosidicallylinked carbohydrate chains on serum glycoproteins. The in vitroglycosylation methodology utilized to modify the recombinantbioscavenger molecule can include, but is not limited to, glycosylationwhere the recombinant protein preparation is incubated with appropriateenzymes in solution or coupled to a solid support. These enzymes includebut are not limited to, glycosltransferases, such as sialtransferases,galactotransferases, and fucosyltransferases.

In one preferred embodiment, following pulmonary delivery, improvedpharmacokinetic profiles (stability) and manufacturing efficiencies oftetrameric and monomeric scavenger molecules, either wild type ormutant, produced in the various expression systems is achieved followingin vitro sialylation of the recombinant glycoproteins to “correct” themicroheterogeneity in their glycosylation profiles.

The rate of detoxification of an OP by a bioscasvenger enzyme moleculeis determined by three parameters: (I) the rate of inhibition of theenzyme by the OP (ii) the rate of aging of the OP-inhibited enzyme and(iii) the rate of reactivation of the enzyme by oximes. Followinginteraction of the OP with the scavenger enzyme, the latter may becomeimmediately inhibited or undergo spontaneous or oxime-inducedreactivation. In the latter case, the reaction of oxime nucleophile withthe phosphonylated enzyme leads to displacement of the phosphonyl groupand restoration of normal activity. In one embodiment of the presentinvention bioscavenger inhalation treatments can be co-administered postexposure with specific oxime molecules which can reactivate the enzymescavenger and thus reducing the amount of scavenger required (Example10). Such oxime molecules include but are not limited to 2-PAM, 1-116,toxogonin, TMB4. This is particularly important, since many potentenzyme scavengers are stoichiometric inhibitors and require large amountof protein for protection (150-200 mg BChE per adult). In one embodimentthe present invention provides mutant BChE clones (e.g. E197Q BChE orE202Q AChE) with a slower rate of aging and thus potentially superiorscavenging capability that are delivered by inhalation as another meansof reducing the amount of enzyme required for protection. In oneembodiment of the present invention, a combination of mutant BChE plusoxime is delivered post-exposure via the lungs to further enhance thescavenging efficacy of nerve agent antidotes.

In general, the process of inhalation is meant to encompass the conceptof delivery of a substance to the blood via the lungs, wherein deliverytakes place across the pulmonary epithelium of an animal. Inhalation canbe via mouth, nose or intratracheal. Most inhalers use the mouth, whichis a preferred method of inhalation in the present invention. Deliveryby inhalation can be by means of an inhaler or nebulizer, many of Whichare known to those of ordinary skill in the art. See, e.g., U.S. Pat. No6,595,202 the contents of which are incorporated by reference herein.Delivery by an inhaler is preferred. Delivery can be an active processof the animal to which the bioscavenger is administered or via a passivemeans. Some pulmonary delivery techniques rely on the inhalation of apharmaceutical formulation by the patient so that the active drug withinthe dispersion can reach the distal (alveolar) regions of the lung. Avariety of aerosolization systems have been proposed to dispersepharmaceutical formulations. For example, U.S. Pat. Nos. 5,785,049 and5,740,794, the disclosures of which are herein incorporated byreference, describe exemplary powder dispersion devices which utilize acompressed gas to aerosolize a powder. Other types of aerosolizationsystems include those which typically have a drug that is stored in apropellant, nebulizers which aerosolize liquids using a compressed gas,and the like.

Many of the advantages of administering BChE by inhalation include thefollowing: non-invasive; user friendly; suitable for repeatedadministration; can deliver small and large molecules/proteins andpeptides; large absorptive surface area for delivery; highly permeablesingle cell membrane; and rapid (depending on compound).

The following examples further illustrate experiments that havedemonstrated reduction to practice and utility of selected preferredembodiments of the present invention, although they are in no way alimitation of the teachings or disclosure of the present invention asset forth herein.

Other objectives, features and advantages of the present invention willbecome apparent from the following specific examples. The specificexamples, while indicating specific embodiments of the invention, areprovided by way of illustration only. Accordingly, the present inventionalso includes those various changes and modifications within the spiritand scope of the invention that may become apparent to those skilled inthe art from this detailed description.

EXAMPLES Example 1

Below are the relevant properties of complex molecules which currentlydetermine whether liquid or powder inhalers are chosen:

Liquid

-   -   1. Inhalers are expensive    -   2. Most proteins are made in a liquid form, thus lower        development costs for some molecules    -   3. Must be kept frozen or cold. RT prior to use    -   4. 50 ul/puff (at 20mg/ml=1 mg puff)    -   5. ˜65% get to the lung=˜650 ug    -   6. Require>200 puffs for 150-200 mg    -   7. Bioavailability (lung to blood, depending on the compound)

Powder

-   -   1. Inhalers are not as expensive    -   2. Must produce a powder. May be difficult and less efficient to        make a large molecule into 1-4μ, particles    -   3. High stability as a powder at RT    -   4. Up to 25-30 mg/puff    -   5. ˜50% gets to the lungs=˜15 mg    -   6. Require 10-15 puffs for 150-200 mg    -   7. Bioavailability (lung to blood, depending on the compound)

Example 2 The Importance of Using Homologous Scavenger Molecules in Vivo

As bioscavengers, molecules must exhibit good bioavailability and goodstability (high mean retention times, MRT) in blood followingadministration. Work in monkeys using purified native macaque BChE(MaBChE), has shown that homologous BChE has a very long retention timein blood (MRT=225+/−19 hours following a single i.v. injection) comparedto current treatments and induces no antibody responses. By comparison,an injection of heterologous human (Hu)BChE into monkeys results in ashort retention time (MRT 33.7+/−2/9 hours) and induces antibodies. Inaddition, the administration of 7,000U (10 mg) of purified homologousmacaque BChE into macaques is known to protect against 2.1 LD50′ of VXand 3.˜LD50 soman with no induction of anti-BChE antibody and no adversetoxicological effects. The development of a human treatment requireevidence in monkeys of similar stability following pulmonary delivery.Life Sciences. Vol 72, p 12 2002.

Example 3 The Effect of Absorption Enhancers on the Bioavailability ofBioscavengers in the Blood Following Pulmonary Delivery.

Oleic acid, dimethyl-b-cyclodextrin and citric acid are initially testedat different concentrations. 1,500-2,000 units of MaBChE are mixed with50 or 250 ug of the different enhancers and the enzyme activity(bioavailability) in the blood is assessed at various times followingintracheal administration into the mid lung.

Example 4 Cloning of MaBChE Gene in Mammalian Cell Expression Vector

For the production of rMaBChE in mammalian or insect cells, plants,transgenic animals and/or insects, the BChE gene from liver of macaquesobtained from National Primate Research Center has been cloned. TotalRNA was isolated from the liver and cDNA was synthesized by reversetranscriptase with oligo dT as primer. The synthesized DNAoligonuclotide primers used for the amplification of MaBChE gene fromthe cDNA were based on the human BChE sequence.

First the MaBChE gene was PCR amplified in two fragments, 5′ and 3′fragments using PfuTurbo DNA Polymerase (Stratagene), and the amplifiedfragments were cloned into pCRII vector (Invitrogen). The 5′ fragmentwas amplified with a pair of primers, O-Pro#11 and Pro#5, and the 3′fragment with O-Pro#4 and Pro#12. The resulting vectors containing thenucleotide sequences encoding NH2-terminal and COOH-terminal fragmentsof MaBChE were digested with appropriate restriction enzymes and clonedinto pcDNA3.1 (Invitrogen) to form a single MaBChE reading frame(pcDNA3.1-MaBChE). The genes cloned in pcDNA3.1 are expressed under thecontrol of CMV promoter and the cells transfected with the vector are tobe selected with G418. The nucleotide sequence of macaque BChE gene inthe constructed vectors was confirmed by commercial sequencing.

Example 5 Cloning of MaBChE Gene in Plant Expression Vector and EnzymeProduction

The production of MaBChE in plant or plant cells requires aplant-specific expression vector. For the optimal activity of therecombinant BChE, after production in plant, the protein is chemicallyglycosylated in the pattern mimics the pattern of endogenousglycosylation. When the proteins are expressed in plant via secretionpathway, they are heavily glycosylated in a plant specific manner whichis problematic to remove for the chemical gycosylation. One means toprevent plant specific glycosylation is to design a vector whichexpresses the transgene in the endoplasmic reticulum and then completeglycosylation in vitro.

For the plant expression vector construct, one useful vector is thepTRAkt plant vector. The nucleotide gene sequence encoding mature MaBChEis PCR amplified utilizing PfuTurbo DNA Polymerase from a previouslyconstructed plasmid vector, pcDNA3.1-MaBChE, with a pair of primerscontaining appropriate restriction enzyme sequences. The resulting about1.8 kb amplified fragment is cloned into an intermediate pCRII vector,The nucleotide sequence of the cloned gene in pCRII vector is sequencedby commercial DNA sequencing. The MaBChE gene is excised from the pCRIIvector with appropriate restriction enzymes and cloned into pTRAkt.

Agrobacterium-Mediated Transient Expression System and PlantTransformation

Agrobacteria is transformed with each of the plant expression vectors byelectroporation. Recombinant Agrobacteria harboring MaBChE gene iscoinfiltrated with the Agrobacteria harboring PRAD fragment into tobaccoleaves by vacuum application. After infiltration, leaves are incubatedadaxial side down, on wetted paper in sealed trays at 23° C. with a 16 hphotoperiod.

After 60 h, leaves are frozen in liquid nitrogen and stored at 80° C.until analyzed. Transient expression by agro-infiltration of tobaccoleaves is highly efficient with accumulation levels being similar tothose found in transgenic plants. Stable proteins yields up to 20-40mg/kg fresh plant material have been obtained. For plant transformation,either tobacco leaf disks or YT-2 suspension cells are co-cultivatedwith recombinant agrobacteria, placed on selective media and regeneratedto intact plant or further cultivated as suspension cells.

Protoplast Preparation

Protoplasts of suspension cells are isolated enzymatically usingCellulase and Pectyolase. The cells are incubated in the enzymesolution, filtered from cellular debris and then washed with buffer.Protoplasts are resuspended in a medium that favors elongative growthand cultured in the dark.

Extraction of Proteins from Infiltrated Leaves.

For the extraction of transiently expressed recombinant proteinsinfiltrated leaves are ground in liquid nitrogen to a fine powder with amortar and pestle. Soluble protein is extracted with extraction buffer,cell debris is removed by two rounds of centrifugation, and thesupernatant is used for expression analyses and further proteinpurification by affinity chromatography or sucrose gradient.

Purification of Protein Extracts from Infiltrated Leaves by AffinityChromatography

Soluble protein is extracted with extraction buffer, cell debris isremoved by two rounds of centrifugation. A Ni-NTA column is equilibratedwith binding buffer, and leaf extract is applied to the column at aconstant flow rate. After sample application, the column is washed withbinding buffer. Nonspecifically bound proteins are removed with bindingbuffer containing 25 mM imidazole. His6-tagged gp120 is eluted by usingbinding buffer containing 250 mM imidazole.

Agrobacterium-Mediated Transient Expression Systems

Agrobacteria is transformed with each of the plant expression vectors byelectroporation. Recombinant Agrobacteria is infiltrated into tobaccoleaves by vacuum application. After infiltration, leaves is incubatedadaxial side down, on wetted paper in sealed trays at 23° C. with a 16 hphotoperiod. After 60 h, leaves are frozen in liquid nitrogen and storedat 80° C. until analyzed. For transient expression in tobacco suspensioncultures, cells are co- cultivated with recombinant Agrobacteria on agarplates first, then transferred to liquid media and incubated for anothertwo days. After harvesting the cells can be frozen and stored untilfurther processed and analyzed.

Purification of Protein Extracts from Infiltrated Leaves by AffinityChromatography

Soluble protein is extracted with extraction buffer, cell debris isremoved by two rounds of centrifugation. A Ni-NTA column is equilibratedwith binding buffer, and leaf extract is applied to the column at aconstant flow rate. After sample application, the column is washed withbinding buffer. Nonspecifically bound proteins is removed with bindingbuffer containing 25 mM imidazole. Tetrameric MaBChE is eluted by usingbinding buffer containing 250 mM imidazole.

Example 6 MaBChE Production in CHO-K1 Cells

Establishment of CHO cells that continuously produces and expressesprimate (monkey or human) BChE demonstrates the principle of thisinvention. CHO cells were used that were stably transduced with a CMV orretroviral vector in which the BChE gene is driven by the long-terminalrepeat regulatory region. For the production of MaBChE, CHO-K1 cellswere transfected with pcDNA3.1-MaBChE vector using LIPOFECTAMINE PLUSreagent (Invitrogen) by the manufacture's procedure. Two days aftertransfection, G418 sulfate was added to the cell at the concentration of400 mg/liter for the transfected cells. After 2 weeks selection, singlecell colonies were prepared by limiting dilution for the isolation ofcells expressing high level of MaBChE. When cells reached nearconfluence, the cell media was changed to fresh media and the cells wereallowed to secrete MaBChE for 2 days. The 2-day media was collected andthe BChE activity measured. The BChE expressed was tested to bebiologically active. Out of 20 single cell-derived transfected colonies,3 colonies showed higher than 0.2 unit/ml.

These expressing cells were then adapted to grow in suspension inCHO-S-SFM (serum-free media). High cell densities, typically 2.0×10⁶cells/ml were obtained from spinner flask cultures. Partial purificationof BChE from CHO cell cultured media revealed that the level ofimpurities in SFM was significantly lower than the serum-supplementedDMEM. This suggests that additional steps need not be employed in thepurification of butyrlcholinesterase from SFM. This would result in areduction of the operating time by 50 h and boost the recovery yield ofBChE to 75%.

To confirm the existence of transgene in the cells expressing high levelof MaBChE, genomic DNA was isolated from cells of each colony. MaBChEnucleotide sequence in the isolated genomic DNA was detected by the PCRamplification using MaBChE specific oligonucleotides.

Example 7

Coexpression of a PRAD Peptide Together with Butyrlcholinesterase inMammalian and Plant Cells Expressing BChE Enhances Tetrameric Forms ofthe Enzyme

The principle of this invention is further demonstrated by the abilityto enhance tetramerization of expressed monomeric butyrlcholinesteraseexpressed in mammalian and plant cells by the co-expression of aproline-rich attachment domain (PRAD).

Data suggest that for optimal detoxification activity by BChE, thetetrameric form of the enzyme is required. A heteromeric form of BChEis, formed by the attachment of the catalytic subunit to a triplehelical collagen-like tail subunit. The function of the collagen-liketail is to anchor catalytic subunits to the basal lamina. The triplehelical association of three collagen-like strands, ColQ, forms thetail. The PRAD of each strand can bind the catalytic subunit tetramerproducing the asymmetric moieties.

The PRAD fragment was amplified using PfuTurbo DNA Polymerase and a pairof synthesized oligonucleotide primers, O-Pro#6 and O-Pro#8, and theamplified fragments were cloned into pCRII vector (Invitrogen). Aplasmid vector of PRAD with FLAG sequence (PRAD-FLAG) at thecarboxyterminal in pCRII vector was also amplified using PfuTurbo DNAPolymerase and a pair of synthesized oligonucleotide primers, O-Pro#6and O-Pro#7 and the amplified fragment was cloned into pCRII vector. Theaddition of FLAG at the carboxyterminal PRAD will allow the purificationof MaBChE tetramer by passing the culture fluid over a FLAG-antibodycontaining column. The nucleotide sequence of both PRAD and PRAD-FLAGhas been confirmed by commercial sequencing of the fragments in thevectors. The nucleotide sequence encoding PRAD and PRAD-FLAG fragmentsare excised from the corresponding vectors with appropriate restrictionenzymes and cloned into pcDNA4 plasmid vector for mammalian cellexpression, and pTRAkt plasmid vector for plant expression.

For the production of tetrameric BChE, CHO-K1 tranfected withpcDNA3.1-MaBChE and expressing high level of MaBChE is retransfectedwith pcDNA4-PRAD or pcDNA4-PRAD-FLAG. The transfected cells are selectedby the addition of zeocine in the media at a concentration of 200mg/liter for 2 weeks. The amount of tetrameric MChE relative to dimerand monomer are determined by northern blot of the media collected after2 days secretion of BChE using anti-BChE antibody. If necessary, highratio of tetramer producing cells are isolated by limiting dilution ofthe transfected cells.

Example 8

Cloning of MaBChE-534stop Encoding BChE Monomeric Molecules

A plasmid vector harboring truncated form of MaBChE which preventstetramerization was made for the production of momomeric MaBChEproduction in mammalian cells. The DNA fragment lacking the sequenceencoding the tertramerization domain was prepared by PCR amplificationof MaBChE gene using PfuTurbo DNA Polymerase with a pair ofoligonucleotide primers, O-Pro#11 and O-Pro#33. The resulted DNAfragment, MaBChE-534stop was cloned into an intermediate pCRII vector.The nucleotide sequence of the truncated MaBChE was confirmed bycommercial sequencing. The MaBChE-534stop DNA fragment was excised fromthe pCRII vector with appropriate restriction enzymes and cloned intopcDNA (pcDNA3.1-MaBChE-534stop) for the expression in mammalian cells.For the expression in plant, the MaBChE-534stop fragment is cloned intopTRAkt.

Example 9

In vitro Post-Translational Modification of Butyrlcholinesterase toProduce a Recombinant Protein with Properties Similar to the Native Form

As previously noted, the native glycosylation profile of any effectivenerve agent scavenger is essential for good in vivo stability and whilemany expression systems have been very successful in expressingfunctional non-gylcosylated proteins, they have been inadequate in termsof preserving the correct glycans on heavily glycosylated proteins suchas BChE. Even though clever molecular engineering and other elegantmanipulations of producer cells, animal or plants are largely overcomingthese problems, they have often met with limited success to date becausethey are imperfect, time consuming and may sacrifice expression levels.An alternate and much more rapid technology is the sialylation of theexpressed purified protein in vitro. The structures with exposed GlcNAcand/or Galactose with remodeling resulting in nearly quantitativecoverage of all galactosyl residues by sialic acid. This technology hasto date been use to successfully remodel>40 compounds and can results inan increase in the number of sialylation sites occupied from of 64% to92%.

Example 10

The Ability of the OP-Inhibited rBChEs to Undergo Spontaneous orOxime-Induced Reactivation

Due to rapid irreversible inhibition of OP-inhibited ChEs, reactivationof the enzyme scavenger is often virtually impossible. This isparticularly the case following interaction with nerve agents such assoman which renders the enzyme non-reactivatable almost immediately. Ata mechanistic level, the reaction between organophosphates and ChEsresults in the creation of phosphylated enzyme complexes involving theactive-center serine (S198 for BChE) followed by either spontaneous orinduced regeneration of the active site. Reaction of OP with theBChE-esterase results in rapid cleavage of the alkoxy-O—P bond and theformation of P---o⁻ conjugates resulting in irreversible inhibition“aging” of some enzyme scavengers. Studies on aging of AChE have beenshown to depend on the structure of the OP, enzyme source, pH,temperature and ionic strength of the solution. The aging process,characteristic of ChEs (in contrast to carboxylesterase) bioscavengers,has stimulated the generation of ChE mutants which are more easilyreactivated than the wild type enzyme. For example, E202Q, an AChEmutant has been shown to be 2-3 times better in detoxifying sarin andsoman, decreased the affinity of soman for AChE, slowed the reactivationof soman-inhibited AChE by HI-6 and decreased aging. In the presence of2 mM of HI-6, the same amount of WT and E202Q AChE could detoxify 135-and 225˜fold molar excess of soman respectively, indicating the superiorproperties of the mutant compared to the WT enzyme

In the latter case, the reaction of oxime nucleophile with thephosphonylated enzyme leads to displacement of the phosphonyl group andrestoration of normal activity. Thus, oximes act on the inactivated ChErather than protect against OP inactivation itself. In this context,exogenously administered FBS AChE inhibited by the powerfulanticholinesterase MEPQ has been shown shown to be reactivated in miceby an i.m. injection of TMB4 (1,1.trimethylene bis(4-hydroxyiminomethylpyridinium) permitting the reactivated enzyme toprotect the mice against exposure to an additional dose of MEPQ.

Example 11

Cloning of E1970 BChE Mutant Gene with Enhanced Scavenging Ability

In an attempt to increase scavenging efficacy, mutants enzyme moleculescan be created which exhibit reduced rates of inhibition followinginteraction with OP as well as a reduced rate of aging, thus allowingpersistence of the active enzyme. In this context, an amino acid change,replacement of 197 glutamic acid to glutamine (E197Q), of hrBChE hasshown better toxic agent scavenging activity. A plasmid vectorharbouring the E197Q mutation in MaBChE (pcDNA3.1-MaBChE-E197Q) has beenconstructed by site-directed mutagenesis. First, E197Q point mutationcontaining oligonucleotides (O-Pro#49 and O-Pro#10) were synthesizedfrom both strands of MaBChE gene in pcDNA3.1-MaBChE plasmid. Twofragments of MaBChE gene were PCR amplified using PfuTurbo DNAPolymerase and two pairs of primers. The 5′-fragment was amplified byO-Pro#11 and O-Pro#10 and the 3′-fragment by O-Pro#9 and O-Pro#12. Theresulting DNA fragments were isolated from the reaction mix by PCRpurification kit (Invitrogen). The amplified and purified 5′- and3′-fragments were mixed and 5 thermal-cycles were performed in thereaction mix without primers to create the full length template. Theresulted full length template containing E197Q mutation, then, diluted100 to 1000 fold and was used as a template to amplify the E197Q MaBChEgene using PfuTurbo DNA Polymerase with O-Pro#11 and O-Pro#12. Theamplified fragment was cloned into an intermediate pCRII vector and thenucleotide sequence was confirmed by commercial sequencing. TheMaBChE-E197Q gene in pCRII vector was excised by appropriate restrictionenzymes and cloned into pcDNA3.1 for the expression in mammalian cells.

1. A method for the treatment of an animal for exposure to a toxicsubstance which comprises administering by inhalation to the lungs ofsaid animal an effective amount of a bioscavenger that prevents oreliminates the toxic effects of said toxic substance in said animal,wherein said toxic substance is an organophosphate or a drug.
 2. Themethod of claim 1 which comprises administering said bioscavenger tosaid animal prior to exposure to said toxic substance.
 3. The method ofclaim 1 wherein said bioscavenger is administered to said animal afterexposure to said toxic substance.
 4. The method of claim 1 wherein saidbioscavenger is delivered at a dose between 1 and 10 mg per Kg of bodyweight of said animal.
 5. The method of claim 1 wherein saidorganophosphate comprises a nerve agent or a pesticide.
 6. The method ofclaim 1 wherein the animal is a human.
 7. The method of claim 1 whereinthe bioscavenger comprises an enzyme that is homologous to said animal.8. The method of claim 1 wherein said drug is selected from the groupconsisting of cocaine, succinylcholine and heroin.
 9. (canceled)
 10. Themethod of claim 1 wherein said bioscavenger is administered byinhalation in powder form or in liquid form.
 11. (canceled)
 12. Themethod of claim 1 wherein said organophosphate is selected from thegroup consisting of sarin isopropyl-methylphosphonofluoridate), VX(ethyl-S-2-diisopropylaminoethyl-phosphano-thiolate), MEPQ(7-(methylethoxyphosphinyloxy)-1-methylquiolinium iodide), soman(pinacolylmethyl-phosphonofluoridate), DFP (diisopylfluorophosphateparaoxon), malathion and parathion. 13.-15. (canceled)
 16. The method ofclaim 1 wherein said bioscavenger molecule is recombinant.
 17. Themethod of claim 16 wherein the recombinant bioscavenger is produced invitro in mammalian or insect cells.
 18. The method of claim 16 whereinthe recombinant bioscavenger is glycosylated.
 19. The method of claim 16wherein the recombinant bioscavenger is made in Chinese Hamster Ovary(CHO) cells.
 20. The method of claim 16 wherein said recombinantbioscavenger is made in a transgenic plant.
 21. The method of claim 16wherein said recombinant bioscavenger is made in a transgenic non-humananimal. 22.-32. (canceled)
 33. The method of claim 1, which furthercomprises administering with said bioscavenger a permeation enhancer.34. The method of claim 33 wherein the permeation enhancer is selectedfrom the group consisting of oleic acid, dimethyl-b-cyclodextrin, citricacid and polyethylene glycol.
 35. The method of claim 1, which furthercomprises co-administration of an oxime, wherein the oxime reactivatessaid bioscavenger.
 36. The method of claim 35 wherein said oxime isselected from the group consisting of 2-PAM, HI6, toxogonin, and TMB4.37. (canceled)